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Risk and outcomes of COVID-19 in patients with oxygen-dependent chronic respiratory failure– a national cohort study

Sundh, Josefin ; Palm, Andreas ; Ljunggren, Mirjam ; Emilsson, Össur Ingi ; Grote, Ludger ; Cajander, Sara ; Li, Huiqi ; Nyberg, Fredrik and Ekström, Magnus LU orcid (2023) In Respiratory Medicine 218.
Abstract

Background: We aimed to evaluate cumulative occurrence and impact of COVID-19 in patients with chronic respiratory failure (CRF) treated with long-term oxygen therapy (LTOT). Material and methods: Data were obtained from the SCIFI-PEARL study on the entire Swedish population and on patients with oxygen-dependent CRF and no COVID-19 diagnosis before start of LTOT. Analyses were performed for three time periods; pre-alpha (Jan–Dec 2020), alpha (Jan–Mar 2021) and delta/omicron (Apr 2021–May 2022). Cumulative incidence of laboratory-verified COVID-19 was compared between patients with CRF and the general population. Risk factors for severe (hospitalised) to critical (intensive care, or death ≤30 days after infection) COVID-19, and the... (More)

Background: We aimed to evaluate cumulative occurrence and impact of COVID-19 in patients with chronic respiratory failure (CRF) treated with long-term oxygen therapy (LTOT). Material and methods: Data were obtained from the SCIFI-PEARL study on the entire Swedish population and on patients with oxygen-dependent CRF and no COVID-19 diagnosis before start of LTOT. Analyses were performed for three time periods; pre-alpha (Jan–Dec 2020), alpha (Jan–Mar 2021) and delta/omicron (Apr 2021–May 2022). Cumulative incidence of laboratory-verified COVID-19 was compared between patients with CRF and the general population. Risk factors for severe (hospitalised) to critical (intensive care, or death ≤30 days after infection) COVID-19, and the impact of COVID-19 on one-year mortality, were analysed using multivariable Cox regression. Results: Cumulative incidence of COVID-19 was higher in patients with CRF than in the general population during the pre-alpha period (6.4%/4.9%, p = 0.002), but less common during the alpha and delta/omicron periods (2.9%/3.8% and 7.8%/15.5%, p < 0.0001 for both). The risk of severe/critical COVID-19 was much higher in CRF patients during all periods (4.9%/0.5%, 3.8%/0.2% and 15.5%/0.5%, p < 0.0001 for all). Risk factors for COVID-19 infection in people with CRF were higher age, cardiovascular and renal disease, and COVID-19 was associated with increased one-year mortality following infection in the pre-alpha (HR 1.79; [95% CI] 1.27–2.53) and alpha periods (1.43; 1.03–1.99). Conclusion: Patients with CRF had higher risk of severe/critical COVID-19 than the general population. COVID-19 infection was associated with excess one-year mortality.

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author
; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
COVID-19, Hypoxic chronic respiratory failure, Long-term oxygen therapy, Mortality, Risk factors
in
Respiratory Medicine
volume
218
article number
107392
publisher
Elsevier
external identifiers
  • pmid:37598894
  • scopus:85168724441
ISSN
0954-6111
DOI
10.1016/j.rmed.2023.107392
language
English
LU publication?
yes
id
4d04adb3-646a-427a-a18c-d132245c4e13
date added to LUP
2023-10-24 15:53:01
date last changed
2024-04-19 02:52:18
@article{4d04adb3-646a-427a-a18c-d132245c4e13,
  abstract     = {{<p>Background: We aimed to evaluate cumulative occurrence and impact of COVID-19 in patients with chronic respiratory failure (CRF) treated with long-term oxygen therapy (LTOT). Material and methods: Data were obtained from the SCIFI-PEARL study on the entire Swedish population and on patients with oxygen-dependent CRF and no COVID-19 diagnosis before start of LTOT. Analyses were performed for three time periods; pre-alpha (Jan–Dec 2020), alpha (Jan–Mar 2021) and delta/omicron (Apr 2021–May 2022). Cumulative incidence of laboratory-verified COVID-19 was compared between patients with CRF and the general population. Risk factors for severe (hospitalised) to critical (intensive care, or death ≤30 days after infection) COVID-19, and the impact of COVID-19 on one-year mortality, were analysed using multivariable Cox regression. Results: Cumulative incidence of COVID-19 was higher in patients with CRF than in the general population during the pre-alpha period (6.4%/4.9%, p = 0.002), but less common during the alpha and delta/omicron periods (2.9%/3.8% and 7.8%/15.5%, p &lt; 0.0001 for both). The risk of severe/critical COVID-19 was much higher in CRF patients during all periods (4.9%/0.5%, 3.8%/0.2% and 15.5%/0.5%, p &lt; 0.0001 for all). Risk factors for COVID-19 infection in people with CRF were higher age, cardiovascular and renal disease, and COVID-19 was associated with increased one-year mortality following infection in the pre-alpha (HR 1.79; [95% CI] 1.27–2.53) and alpha periods (1.43; 1.03–1.99). Conclusion: Patients with CRF had higher risk of severe/critical COVID-19 than the general population. COVID-19 infection was associated with excess one-year mortality.</p>}},
  author       = {{Sundh, Josefin and Palm, Andreas and Ljunggren, Mirjam and Emilsson, Össur Ingi and Grote, Ludger and Cajander, Sara and Li, Huiqi and Nyberg, Fredrik and Ekström, Magnus}},
  issn         = {{0954-6111}},
  keywords     = {{COVID-19; Hypoxic chronic respiratory failure; Long-term oxygen therapy; Mortality; Risk factors}},
  language     = {{eng}},
  publisher    = {{Elsevier}},
  series       = {{Respiratory Medicine}},
  title        = {{Risk and outcomes of COVID-19 in patients with oxygen-dependent chronic respiratory failure– a national cohort study}},
  url          = {{http://dx.doi.org/10.1016/j.rmed.2023.107392}},
  doi          = {{10.1016/j.rmed.2023.107392}},
  volume       = {{218}},
  year         = {{2023}},
}